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Papers by Patrizio Polisca

Anais Brasileiros de Dermatologia, 2015

We describe herein what is to our knowledge the first reported case of an invasive cutaneous meta... more We describe herein what is to our knowledge the first reported case of an invasive cutaneous metastasis with unknown primary, electively treated solely with electrochemotherapy. We describe a female patient with a large, invasive and painful lesion in her hypogastric region, extending up to the pubic area. The cutaneous biopsy and instrumental and laboratory analyses, all failed to reveal the primary site. A final diagnosis of cutaneous metastasis with unknown primary was made and treatment was performed with electrochemotherapy. Our case highlights the importance of interdisciplinary choices in clinical practice to cope with the lack of a primary site and to improve quality of life, since no standardized therapy exists for these classes of patients.

Türk Üroloji Dergisi/Turkish Journal of Urology, 2015

Cutaneous metastases may be the first sign of clinically silent visceral cancer. Approximately 30... more Cutaneous metastases may be the first sign of clinically silent visceral cancer. Approximately 30% of patients with primary renal cell carcinoma present with metastatic disease, and only 8% of them have skin metastases. We present the case of a 59-year-old male patient with a subcutaneous nodular on the upper chest extending to the jugular region. The lesion appeared skin colored and was not painful and 5 cm x 3.5 cm in diameter. The histological examination of the cutaneous biopsy showed an infiltration of undifferentiated epithelial cells positive to cytokeratins AE1/AE3, whereas they were negative to CK-20, CK5/6, cluster of differentiation 10, vimentin, thyroid transcription factor-1, S-100, human melanoma black-45, hepatocytespecific antigen, carcinoembryonic antigen, and chromogranin A. A total-body computed tomography (CT) showed the presence of a tumoral lesion in the left kidney with multiple metastases in the lung, brain, and bones. According to the cutaneous biopsy and total-body CT, a final diagnosis of an undifferentiated renal carcinoma presenting as a subcutaneous metastasis was made. A chemotherapeutic treatment with gemcitabine and cisplatin resulted in the stabilization of the renal and metastatic lesions with an improvement in the quality of life of the patient. Considering that the prognosis of patients with cutaneous metastases is very poor, it is necessary to obtain an appropriate diagnosis in order to identify patients with treatable disease with the purpose of starting a therapeutic protocol.

Journal of the American College of Cardiology, 1995

ABSTRACfS lACC February 1995 tients with NCA (p < 0.05 vs pre-mental stress) in contrast to no va... more ABSTRACfS lACC February 1995 tients with NCA (p < 0.05 vs pre-mental stress) in contrast to no vasodilation in patients with CAD (p = NS). 5 CAD patients underwent repeat mental stress (MS), following intracoronary phentolamine (P) 0.02 mglkg. Methods: Coronary flow velocimetry(Doppler-tipped guidewirej and quantitative angiography were performed in a non-stenotic artery at control (Con), and during a maximally dilating dose of intracoronary adenosine before and after nitroglycerin (NTG) 100 JLg i.c. in 6 patients. CFR was measured conventionally using peak/rest flow velocity changes alone (Vel) and flow estimates incorporating angiographic vessel cross-sectional area (VxA).

Giornale italiano di cardiologia, 1999

Intracoronary stenting, conventional coronary artery bypass with cardiopulmonary bypass and minim... more Intracoronary stenting, conventional coronary artery bypass with cardiopulmonary bypass and minimally invasive direct coronary artery bypass without extracorporeal circulation are the three accepted options for revascularizing the left anterior descending coronary artery. We compare the effects of these three procedures in terms of minor myocardial damage and systemic inflammatory response. Ninety patients undergoing left anterior descending coronary artery revascularization with these three different techniques (thirty patients per group) were considered. Blood samples were collected preoperatively and immediately postoperatively, and then 24, 48 and 72 hours after the procedures to measure troponin I, creatine kinase, its MB fraction and C-reactive protein levels. Postoperative levels of troponin I and MB-creatine kinase were significantly higher in conventional coronary grafting group than in PTCA-stent and in the minimally invasive surgery groups (p < 0.0003), while in both s...

Neuropharmacology, 2017

The accumulation of b-amyloid (Ab) is one of the hallmarks of Alzheimer disease (AD). Beyond the ... more The accumulation of b-amyloid (Ab) is one of the hallmarks of Alzheimer disease (AD). Beyond the inflammatory reactions promoted by Ab, it has been demonstrated that the prokineticin (PK) system, composed of the chemokine prokineticin 2 (PK2) and its receptors, is involved in Ab toxicity. In this study we have analyzed how the Ab chronic treatment affects the glutamatergic transmission on neurons from primary cortical cultures, clearly demonstrating the PK system involvement on its action mechanism. In fact, we have observed a significant increase of the ionic current through the AMPA receptors in primary cortical neurons and an up-regulation of the PK system in cultures chronically treated with Ab. All effects were nullified by the prokineticin antagonist PC-1. Moreover, we have herein firstly demonstrated that the incubation of primary cortical culture with Bv8, the amphibian homologue of PK2, was able to increase in neurons the AMPA currents at specific doses and exposure times, measured both as evoked and as spontaneous currents. This effect was not due to a modification of the AMPA receptor subunit expression. In contrast, the up-modulation of AMPA currents were blocked by PC-1 and were mediated by the activation of the intracellular protein kinase C (PKC) transduction pathways because G€ o6983, the PKC inhibitor added in the medium, nullified the effect. Finally, cellular death induced by kainate was also reduced following treatment with PC1. In conclusion, our results show that the prokineticin system may be a key mediator in the Ab-induced neuronal damage, suggesting PK antagonists as new therapeutic compounds to ameliorate the AD progression.

The Annals of Thoracic Surgery, 2008

Objectives Conducting system defects are common in patients with aortic valve disease. Aortic val... more Objectives Conducting system defects are common in patients with aortic valve disease. Aortic valve replacement may result in further conduction abnormalities requiring permanent pacemaker implantation. The aim of our study was to identify the incidence and predictors for postoperative 30-day permanent pacemaker implantation in patients undergoing isolated aortic valve replacement, and the effect of an accurate surgical technique in order to prevent permanent pacemaker implantation. Methods Data from 261 consecutive patients (mean age 69 W 12 years, 136 men) undergoing isolated aortic valve replacement from January 2004 to January 2008 were analyzed retrospectively. Indications for aortic valve replacement were aortic valve stenosis (n U 156), stenoinsufficiency (n U 63), regurgitation (n U 42). Aortic bicuspid valve was present in 25% of cases (n U 64), redo operation was the indication in 7% (n U 18). Preoperative conducting system disease, defined as first-degree atrioventricular block, left or right bundle-branch block or left anterior hemiblock, was present in 25.6% (n U 67) of patients. An accurate surgical technique for debridement of calcific material was performed. Results In-hospital mortality was 0.8% (2 out of 261 patients). Postoperatively, 8 out of 261 patients (3%) required permanent pacemaker implantation, for seconddegree (n U 1) or complete atrioventricular block (n U 7). Incidence of permanent pacemaker implantation was similar for patients either with or without preoperative conducting system disease (25 vs. 25.7%, P U NS). Independent predictors of permanent pacemaker implantation were greater preoperative end-systolic diameter (P U 0.026) and left ventricular septum hypertrophy (P U 0.041). Conclusions Need of permanent pacemaker implantation after aortic valve replacement seems to be related more to preoperative advanced aortic valve disease rather than preexisting conducting system abnormalities. An accurate surgical technique for aortic valve replacement probably helps to prevent further impairment of conducting system function requiring early postoperative permanent pacemaker implantation.

The Annals of Thoracic Surgery, 2009

Background. Coronary artery bypass grafting (CABG) is a well-accepted therapeutic strategy for pa... more Background. Coronary artery bypass grafting (CABG) is a well-accepted therapeutic strategy for patients with multivessel coronary artery disease and left ventricular dysfunction. The aim of the study was to evaluate longterm results after CABG in patients with preoperative left ventricular ejection fraction (LVEF) of 0.35 or less. Methods. Data from 302 consecutive patients (mean age, 62 ؎ 8.7 years) with LVEF of 0.35 or less who had undergone CABG were analyzed. Epinephrine and enoximone with or without norepinephrine were used to increase cardiac index. Intra-aortic balloon pump or left ventricular assist devices, or both, were used in case of postoperative low output syndrome. Results. Complete revascularization was achieved in 298 of 302 patients (98.7%); internal thoracic artery was used in 294 (97.4%). Operative mortality was 5.3%; independent predictors of operative mortality were emergency CABG (p ‫؍‬ 0.005), history of ventricular arrhythmias (p ‫؍‬ 0.007), and previous anterior myocardial infarction (p ‫؍‬ 0.05). At follow-up, all-cause mortality was 30.8%, and 10-year survival was 63% ؎ 4%; independent predictors of late all-cause mortality were history of ventricular arrhythmias (p < 0.0001), chronic renal dysfunction (p ‫؍‬ 0.0004), and diabetes mellitus (p ‫؍‬ 0.04). Cardiac death was 20.4%, and 10-year freedom from cardiac death was 73% ؎ 3.3%; independent predictors of cardiac death were history of ventricular arrhythmias (p ‫؍‬ 0.004), chronic renal dysfunction (p ‫؍‬ 0.03), and more than one previous anterior myocardial infarction (p ‫؍‬ 0.004). At 80 ؎ 44 months of follow-up, echocardiography showed significant LVEF improvement (0.43 ؎ 0.09 versus 0.28 ؎ 0.06, p < 0.0001). Ten-year freedom from myocardial infarction was 87% ؎ 3%. Conclusions. Excellent long-term results after CABG can be expected for patients with LVEF of 0.35 or less. Complete revascularization and internal thoracic artery grafting are associated with high freedom from myocardial infarction. Careful treatment of arrhythmias, diabetes, and renal dysfunction is necessary to improve longterm survival.

Catheterization and …, 2002

We report a case of acute left ventricular failure after transcatheter closure of a single secund... more We report a case of acute left ventricular failure after transcatheter closure of a single secundum atrial septal defect in a 68-year-old man with coronary artery disease. Just before the procedure, two coronary lesions had been treated with direct stenting. Transcatheter closure of atrial septal defects should always be deferred in ischemic heart disease patients who need percutaneous myocardial revascularization.